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Axillary Block Complicated by Hematoma and Radial Nerve Injury
  1. Bruce Ben-David, M.D.* and
  2. Shalom Stahl, M.D.
  1. *From the Department of Anesthesia, Herzlia-Haifa (Horev) Medical Center, Haifa, Israel
  2. The Hand Surgery Unit, Rambam Medical Center, Haifa, Israel.
  1. Reprint requests: Bruce Ben-David, M.D., Medical Director, Herzlia-Haifa (Horev) Medical Center, Haifa, Israel.


Background and Objectives. Hematoma is typically cited as one mechanism of nerve injury following axillary block. However, documented cases of this are lacking.

Methods. A healthy 38-year-old man was scheduled for surgical removal of a tumor of the hand. A transarterial axillary block was performed with a 22-gauge short-bevel needle using 40 mL of a mixture of equal volumes of 1.5% lidocaine and 0.5% bupivacaine containing 1:200,000 epinephrine. No paresthesias were reported. Post-operative, the patient developed a large axillary hematoma accompanied by paresthesias and radial nerve weakness.

Results. With conservative management, nerve recovery was complete in 6 months.

Conclusions. Hematoma complicating axillary block may result in nerve dysfunction.

  • regional anesthesia and pain management
  • brachial plexus block
  • neurologic complications.

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